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Physical Therapy for People with Huntington Disease: Current Perspectives and Case Report

Huntington disease (HD) is a neurodegenerative disease that results in a progressive loss of functional abilities. Impairments in voluntary movements and the presence of involuntary movements are a contributing factor to functional decline. Despite the discovery of the gene that causes HD in 1993, effective interventions to retard disease progression continue to elude scientists and clinicians. Physical therapy is sometimes underutilized in people with HD, possibly due to the progressive nature of the disease, and the complexity of cognitive and psychiatric problems that are common in people with HD. Physical therapists can enable people with HD to optimize their quality of life and overall functional abilities by addressing health and wellness issues, educating them about falls prevention, teaching them how to minimize the effects of primary impairments such as dystonia and bradykinesia, and teaching them how to counteract the effects of secondary impairments on activity and participation. Case study: A 49-year-old male living at home, who was diagnosed with HD 17 years ago, participated in a 14-week exercise program to reduce impairments and activity limitations related to balance and postural control. Physical therapy consisted of a home program, which included exercises and tasks designed to promote balance, coordination, and flexibility. Over the course of the program, disability was reduced on numerous aspects of the SF-36, the number of falls decreased, self-selected walking speed increased by 0.77 ft/sec; performance on the Berg Balance Scale improved by 9 points, and the Unified Huntington Disease Rating Scale (UHDRS) total motor score decreased by 12 points. In light of these findings, physical therapy examination and treatment strategies are recommended as a basis for minimizing impairments and maintaining functional abilities in people with this progressive neurological condition.